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J Ultrasound Med. 2018 Mar;37(3):689-696. doi: 10.1002/jum.14406. Epub 2017 Sep 6.

Lung Ultrasonography in Patients With Idiopathic Pulmonary Fibrosis: Evaluation of a Simplified Protocol With High-Resolution Computed Tomographic Correlation.

Author information

1
Departments of Medical Imaging, University Hospital of Heraklion, Heraklion, Crete, Greece.
2
Department of Medical Imaging, Queen's Medical Center, Nottingham University Hospital, Nottingham, England.
3
Thoracic Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece.

Abstract

OBJECTIVES:

To compare a simplified ultrasonographic (US) protocol in 2 patient positions with the same-positioned comprehensive US assessments and high-resolution computed tomographic (CT) findings in patients with idiopathic pulmonary fibrosis.

METHODS:

Twenty-five consecutive patients with idiopathic pulmonary fibrosis were prospectively enrolled and examined in 2 sessions. During session 1, patients were examined with a US protocol including 56 lung intercostal spaces in supine/sitting (supine/sitting comprehensive protocol) and lateral decubitus (decubitus comprehensive protocol) positions. During session 2, patients were evaluated with a 16-intercostal space US protocol in sitting (sitting simplified protocol) and left/right decubitus (decubitus simplified protocol) positions. The 16 intercostal spaces were chosen according to the prevalence of idiopathic pulmonary fibrosis-related changes on high-resolution CT. The sum of B-lines counted in each intercostal space formed the US scores for all 4 US protocols: supine/sitting and decubitus comprehensive US scores and sitting and decubitus simplified US scores. High-resolution CT-related Warrick scores (J Rheumatol 1991; 18:1520-1528) were compared to US scores. The duration of each protocol was recorded.

RESULTS:

A significant correlation was found between all US scores and Warrick scores and between simplified and corresponding comprehensive scores (P < .0001). Decubitus simplified US scores showed a slightly higher correlation with Warrick scores compared to sitting simplified US scores. Mean durations of decubitus and sitting simplified protocols were 4.76 and 6.20 minutes, respectively (P < .005).

CONCLUSIONS:

Simplified 16-intercostal space protocols correlated with comprehensive protocols and high-resolution CT findings in patients with idiopathic pulmonary fibrosis. The 16-intercostal space simplified protocol in the lateral decubitus position correlated better with high-resolution CT findings and was less time-consuming compared to the sitting position.

KEYWORDS:

B-lines; chest-lung; high-resolution computed tomography; idiopathic pulmonary fibrosis; lung ultrasonography; simplified protocol; ultrasound techniques/physics

PMID:
28877354
DOI:
10.1002/jum.14406
[Indexed for MEDLINE]

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